Provider Demographics
NPI:1568936805
Name:PEARSON, JAMES DAVID (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DAVID
Last Name:PEARSON
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:DAVID COOMBS
Other - Last Name:PEARSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARM D
Mailing Address - Street 1:11701 CRAIG ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2536
Mailing Address - Country:US
Mailing Address - Phone:913-522-1493
Mailing Address - Fax:
Practice Address - Street 1:3411 NE RALPH POWELL RD
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064-2361
Practice Address - Country:US
Practice Address - Phone:888-818-8848
Practice Address - Fax:855-496-2998
Is Sole Proprietor?:No
Enumeration Date:2019-01-21
Last Update Date:2019-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-14957183500000X
NE15613183500000X
MO2010034684183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist